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May 1, 2012 - April 30, 2013
Remittance Advice Alerts/PROMISe Banner Pages
Subject: Fee-for-Service Low-Cost Outlier / High-Cost Outlier Threshold Adjustment and Relative Weight Adjustments
Banner Date: August 4, 2012
Cycle: 6
Provider Type/Specialties: 01/010
Claim Types: I and A
Banner Date: August 4, 2012
Cycle: 6
Provider Type/Specialties: 01/010
Claim Types: I and A
Subject: Fee-for-Service Low-Cost Outlier / High-Cost Outlier Threshold Adjustment and Relative Weight Adjustments
On May 7, 2012, Low-Cost Outlier policy, High Cost Outlier Threshold Adjustment and the Relative Weight Adjustments for inpatient Fee-for-Service claims billed by acute care general hospitals with dates of discharge on or after July 1, 2011 were implemented consistent with the approved state plan.
As stated in the Remittance Advice banner pages published in cycles 45, 46, and 47 in May 2012, the department is processing mass adjustments of claims paid prior to May 7, 2012 for dates of discharge on or after July 1, 2011. This is the second and final mass adjustment completed the weekend of August 4, 2012 and includes claims with discharge dates from November 1, 2011 through May 6, 2012. The claim adjustments can be identified on this Remittance Advice by ICN range 5212213000001 through 5212214333280.
As stated in the Remittance Advice banner pages published in cycles 45, 46, and 47 in May 2012, the department is processing mass adjustments of claims paid prior to May 7, 2012 for dates of discharge on or after July 1, 2011. This is the second and final mass adjustment completed the weekend of August 4, 2012 and includes claims with discharge dates from November 1, 2011 through May 6, 2012. The claim adjustments can be identified on this Remittance Advice by ICN range 5212213000001 through 5212214333280.
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Last Modified:8/3/2012 9:45
